Clinical Report: Diverse Perspectives on Abortion Access Reform Initiatives in Madagascar

Background

Access to safe abortion services is critically limited in Madagascar, where abortion laws are among the most restrictive in sub-Saharan Africa. Civil society organizations face significant challenges due to internal divisions and external pressures such as the US global gag rule.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• Divisions within the pro-choice movement in Madagascar affect advocacy efforts.
• The US global gag rule and anti-gender movements restrict civil society mobilization.
• Effective issue framing is crucial for placing abortion law reform on the political agenda.
• Coalition building is hampered by competition for resources among civil society organizations.
• Regional learning and exchange may help overcome national divisions in advocacy.

Clinical Implications

Civil society organizations must navigate internal divisions to effectively advocate for abortion law reform. Strengthening coalitions and improving issue framing can enhance their impact on public policy.

Conclusion

Addressing the challenges faced by civil society in Madagascar is essential for advancing abortion law reform and improving reproductive rights in the region.

Related Resources & Content

1. Frontiers in Reproductive Health, 2026 -- Beyond the 72 h window: operationalizing safe abortion as essential care for sexual violence survivors in humanitarian settings
2. Frontiers in Reproductive Health, 2026 -- The Mashujaa Network: youth-driven resilience for reproductive health and safe abortion in conflict-affected communities
3. Frontiers in Reproductive Health, 2026 -- Framing menstrual regulation as a pathway to advancing reproductive autonomy in restrictive legal contexts
4. JAMA Network Open, 2023 -- Mexico-Based Accompaniment Collectives for Abortion in the US After Dobbs
5. Recommendations and best practice statements across the continuum of abortion care - Abortion care guideline, second edition, NCBI Bookshelf
6. Randomized Trial of Very Early Medication Abortion - PubMed
7. Recommendations and best practice statements across the continuum of abortion care - Abortion care guideline, second edition - NCBI Bookshelf
8. Randomized Trial of Very Early Medication Abortion - PubMed